Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Am J Emerg Med. 2012 Jan;30(1):26-31. doi: 10.1016/j.ajem.2010.07.023. Epub 2010 Oct 14.
Angioembolization is an effective adjunct to the management of retroperitoneal hemorrhage in pelvic fractures. Most patients with stable-type pelvic fracture are treated conservatively. However, in some stable pelvic fracture cases, patients should receive angioembolization for hemostasis upon incidental finding of contrast extravasation on computed tomography (CT). In this study, we attempted to define the characteristics of patients with stable pelvic fracture requiring angioembolization.
We retrospectively reviewed the charts of patients with pelvic fractures between January 2005 and November 2009. We focused on stable pelvic fracture patients with contrast extravasation on CT who then received angioembolization. The demographics, Injury Severity Score (ISS), Abbreviated Injury Scale score, and the blood glucose levels on admission were analyzed.
In total, 334 patients were enrolled. Patients with higher blood glucose level on admission with stable pelvic fracture had a higher rate of angioembolization. Furthermore, these patients presented with a higher Abbreviated Injury Scale score and ISS.
In patients with stable pelvic fracture, higher blood glucose level on admission was associated with a higher likelihood of needing angioembolization. Blood glucose level should be checked during the initial survey of a pelvic fracture, and greater attention should be given to patients with higher blood glucose level or with an ISS of 25 or greater, even when the imaging study only reveals a stable pelvic fracture.
血管栓塞术是骨盆骨折后治疗腹膜后出血的有效辅助手段。大多数稳定型骨盆骨折患者采用保守治疗。然而，在一些稳定型骨盆骨折病例中，当 CT 偶然发现造影剂外渗时，患者应接受血管栓塞术止血。在本研究中，我们试图确定需要血管栓塞术止血的稳定型骨盆骨折患者的特征。
我们回顾性分析了 2005 年 1 月至 2009 年 11 月期间骨盆骨折患者的病历。我们重点关注 CT 显示造影剂外渗且随后接受血管栓塞术的稳定型骨盆骨折患者。分析了患者的人口统计学资料、损伤严重程度评分（ISS）、简明损伤评分和入院时的血糖水平。
共纳入 334 例患者。入院时血糖水平较高的稳定型骨盆骨折患者更需要血管栓塞术。此外，这些患者的简明损伤评分和 ISS 更高。
在稳定型骨盆骨折患者中，入院时的血糖水平与更需要血管栓塞术的可能性相关。在骨盆骨折的初步检查中应检查血糖水平，对于血糖水平较高或 ISS 为 25 或更高的患者，即使影像学检查仅显示稳定型骨盆骨折，也应给予更多关注。
